Service Request No.: Date: D D M M Y Y Y Y No.

(Update Your Latest Contact/Address/ AN/Mo!i"e #an$in% Detai"s/Aad&ar nu'!er( )or Resident *ndividua"s+ Custo'er Detai"s , #an$ Account: *(direct Account: Loan: ( "ease -i"" in a"" t&e detai"s in CA *.AL L/../RS and use #LAC0 *N0 on"y. )ie"ds 1it& , (asteris$+ are 'andatory + , Na'e: Mr./Ms./Mrs./Dr. ...................................................................................................................................................... ( ri'ary App"icant+: )irst Na'e Midd"e Na'e Last Na'e Custo'er Dec"aration "ease revise 'y/our records/ contact detai"s 1it& your #an$ -or t&e accounts t&at are &e"d !y 'e or us Ne1 Co''unication Address: De'at Account: Credit Card:

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City: , in code: .e" No. (o--ice+: /('ai" *D :

State: .e" No. (res.+: ,Mo!i"e No:

*- your ne1 co''unication address is di--erent -ro' your per'anent address2 p"ease %ive t&e detai"s !e"o1: er'anent Address:

City: , in code: .e" No. (o--ice+:

State: .e" No.(res+ :

3 )or c&an%e o- address2 p"ease su!'it re"evant address proo- 1&ic& 1i"" !e veri-ied 1it& t&e ori%ina" !y o--icia"s. *- you do not 1ant your savin%s account state'ents sent to your co''unication address2 p"ease tic$ &ere. AN Updation: "ease update 'y AN as docu'ent proo- is enc"osed -or t&e #an$4s records.+ in t&e a!ove 'entioned account. (.&e copy o- AN

Unique *denti-ication nu'!er (Aad&ar+ Updation: "ease update 'y Aad&ar Nu'!er in t&e a!ove 'entioned savin% !an$ account. (.&e copy o- Unique *D card as docu'ent proo- is enc"osed -or t&e #an$4s records+ Mo!i"e #an$in% )aci"ity: */5e &ere!y re%ister -or t&e 'o!i"e !an$in% -aci"ity o--ered !y *C*C* #an$. */5e con-ir' and underta$e t&at */1e &ave read and understood t&e .er's and Conditions %overnin% t&e 'o!i"e !an$in% -aci"ity o- *C*C* #an$ as 'entioned / speci-ied on 111.icici!an$.co'. .ic$ &ere to con-ir' C&ec$in% your account !a"ance or requestin% a 'ini state'ent2 !an$in% is no1 easy as 'essa%in% a -riend. 5it& SMS2 you can stay in touc& 1it& your account 1it& 6ust a -e1 $ey 1ords. Si'p"y SMS t&e -o""o1in% $ey1ords to 7898988 or :;<91=>=>= #a"ance *nquiry : SMS *#AL ?? "ast 8 di%it o- account?? Last transactions : SMS *.RAN ?? "ast 8 di%it o- account?? C&eque !oo$ request : SMS *C#R ?? "ast 8 di%it o- account?? Last transactions : SMS *SCR ?? "ast 8 di%it o- account?? Last transactions : SMS *CS* ?? "ast 8 di%it o- account??

*/5e &ere!y understand t&at: A"" t&e particu"ars -i""ed in t&e -or' are true2 correct2 co'p"ete and up(to(date in a"" respects and no in-or'ation is 1it&&e"d. */5e understand t&at certain particu"ars %iven !y 'e/us are required as per t&e operationa" %uide"ines %overnin% !an$in% co'panies. *C*C* #an$ reserves t&e ri%&t to re6ect t&e request -or updatin% C&an%e o- address/Mo!i"e nu'!er//('ai" *D/ AN updation /Aad&ar nu'!er / Mo!i"e #an$in% -aci"ity -or one or 'ore o- t&e products/services 1it&out assi%nin% any reason. *- inco'p"ete or inaccurate in-or'ation is %iven2 *C*C* #an$2 !e-ore re6ectin%/acceptin% any o- t&e a!ove request -or any o- its products2 &as t&e ri%&t to as$ -or additiona" docu'ents. *t is 'y/our responsi!i"ity to in-or' *C*C* #an$ i''ediate"y i- t&ere is any c&an%e in t&e address/'o!i"e nu'!er/ e('ai" *D 'entioned &erein and to provide -urt&er in-or'ation as 'ay !e required !y *C*C* #an$. Mo!i"e #an$in% -aci"ity is not o--ered -or 6oint"y operated accounts. 3 * con-ir' t&at * &ave t&e necessary aut&ority/'andate -ro' a"" t&e 6oint account &o"ders to si%n t&is dec"aration on !e&a"- o- 'yse"- and a"" t&e 6oint &o"ders -or a"" t&e products and services 'entioned &erein. Custo'er Si%nature(s+:

Si%nature

Si%nature

Si%nature

Na'e @@@@@@@@@@@@@@@@@@@ ,( ri'ary App"icant + #ranc& Use Bn"y

Na'e @@@@@@@@@@@@@@@@@@@@@@@@@@@ ,(Aoint App"icant 1+

Na'e @@@@@@@@@@@@@@@@@@@@@@@@@@@ ,(Aoint App"icant >+

Dec"aration !y #ranc& B--icia" C * con-ir' .&e detai"s 'atc& 1it& t&e #an$4s records .&e app"icant(s+ si%ned in 'y presence and t&e si%nature(s+ &ave !een veri-ied 1it& t&e #an$ records Docu'entary proo- is enc"osed (*- t&e account activation date is "ess t&an 8 'ont&s -ro' t&e date o- app"ication+ A"" docu'ents are veri-ied 1it& ori%ina" and attested Account is not *nactive / Dor'ant / )roDen / in De!it !a"ance Address c&an%e aut&orised *dentity proo- is attac&ed -or t&e 'o!i"e !an$in% -aci"ity )or updation in De'at account/*(direct account : Lin$ed #an$ account no. E.............................. .radin% user *D (-or *C*C*Direct.co' account on"y E.........................................

Custo'er *D: , Sta-- /'p"oyee *D : @@@@@@@@@@@@@@@@@@@@@@ Si%nature o- #an$ B--icia" @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ *C*C*/RS F/G1/H81>/L*A#/S.AYCBNN/C./D #an$ Sea"

Ac$no1"ed%e'ent s"ip (.o !e -i""ed !y t&e #an$ Sta--+ Date: D D M M Y Y Y Y Received -ro' : @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ A/c. No. @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ -or c&an%e oaddress/contact detai"s/e('ai"/ AN/Mo!i"e a"ert /Aad&arnu'!er -or your: #an$ Account De'at Account *C*C* Direct Credit Cards Loans .&e necessary c&an%es 1i"" !e carried out in t&e #an$s records on"y -or t&e account 'entioned a!ove. *C*C* #an$ (#ranc& Na'e + : @@@@@@@@@@@@@@@@@@@@@@@ Si%nature o- #an$ B--icia" @@@@@@@@@@@@@@@@@ #an$ Sea"